Household bleach is a common cleaning product containing sodium hypochlorite, a highly alkaline chemical. When this substance contacts the delicate tissues of the eye, it creates a medical emergency requiring immediate action to prevent severe damage. Alkaline substances are corrosive and can rapidly cause a chemical burn. The severity of the injury depends directly on the bleach concentration and the speed with which the eye is treated.
The Severity of Bleach Exposure and Vision Risk
The risk of permanent vision loss from bleach exposure depends significantly on the product’s concentration and the immediate response. Household bleach typically has a pH of about 12, which is significantly higher than the eye’s neutral pH of around 7. Irreversible damage to ocular tissue can begin with substances having a pH of 11.5 or higher.
Alkaline chemicals are particularly dangerous because they cause liquefaction necrosis. This process allows sodium hypochlorite to quickly penetrate deep into the eye’s structure, unlike acid burns, which often coagulate tissue and form a barrier. The chemical rapidly passes through the cornea and can reach internal structures like the lens and iris within minutes.
This deep penetration can damage the corneal stem cells, which are responsible for renewing the corneal surface. Damage to these cells can lead to persistent clouding of the cornea, causing blurred or reduced vision. If the chemical reaches internal structures, it can lead to complications such as cataract formation or secondary glaucoma, which raises fluid pressure inside the eye. The outcome rests heavily on the rapid, thorough removal of the chemical.
Immediate Response: Essential First Aid
The most important step following bleach exposure is immediate copious irrigation of the affected eye with water. Every second counts, as the chemical continues to burn and penetrate tissue until it is diluted and washed away. The goal is to flush the chemical out and restore the eye’s natural pH level quickly.
Begin rinsing the eye with clean, cool, or lukewarm tap water for a minimum of 15 to 20 minutes continuously. Tap water is the most available and acceptable irrigating fluid in an emergency. Do not delay irrigation to search for sterile saline solution, as the time lost is detrimental than using tap water.
To irrigate effectively, hold the eyelids open to ensure the water reaches all surfaces of the eye, including under the lids. If only one eye is affected, tilt your head so the water runs away from the unaffected eye, preventing cross-contamination. This can be done by standing under a gentle shower stream or using a large, clean cup to pour water steadily over the eye.
If you are wearing contact lenses, remove them immediately, during rinsing or as soon as they can be safely accessed. Leaving them in can trap the corrosive chemical against the eye’s surface, worsening the burn. Continue flushing for the full duration, even if the eye feels better, before seeking professional medical attention.
Professional Medical Evaluation and Recovery
After the 15 to 20 minutes of home irrigation, immediate transportation to an emergency room or an eye specialist is necessary. Medical professionals will continue irrigation, often using specialized sterile solutions, and may check the eye’s surface pH level. This pH check confirms that the corrosive chemical has been neutralized.
A thorough ophthalmologic examination, typically using a slit-lamp microscope, will be performed to assess the damage to the cornea and conjunctiva. Treatment may involve topical ophthalmic antibiotics to prevent infection and cycloplegic drops to relax eye muscles and reduce pain. Topical steroids may also be prescribed to manage inflammation, though their use requires careful monitoring by a specialist.
For minor burns, recovery may occur within a day or two with supportive care, such as artificial tears and pain relief. More severe burns may require hospitalization for intensive treatment and monitoring. Long-term interventions for severe injuries can include surgical procedures such as corneal transplantation or specialized stem cell therapy to restore a healthy ocular surface. The recovery timeline and final visual outcome are directly related to the severity of the initial burn and the timeliness of first aid and subsequent medical care.